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Rawlins Student Acquires Skills to Improve Health Care in Wyoming

August 21, 2014

University of Wyoming student Shandra Shepard of Rawlins has always wanted to work with people in the health care field, and she’s realizing her dream by enrolling in the University of Wyoming’s new Doctor of Nursing Practice (DNP) program.

“It gives NPs (nurse practitioners) the skills and ability to provide the highest quality of care and to be competent and confident providers,” Shepard says. “The DNP degree offers more to the NP role in that more education, opportunity for research and publication, and clinical time are offered. The biggest thing for me is the patient and family focus that NPs are taught. Not to say that other providers don’t offer this, but it is a big part of the NP role and essential in health care.”

UW’s trustees in 2010 approved the new DNP program as part of a national shift to offer extended training for nurse practitioners and in response to Wyoming’s health care needs, says Mary Burman, dean of the Fay W. Whitney School of Nursing. The first DNP students enrolled in the fall semester of 2012 and will enter the workforce in 2015.

“Most of the counties in Wyoming are underserved in terms of mental health care, and part of our DNP program focuses on nurse practitioners who work in psychiatric mental health,” Burman says. “The other piece of it is in primary care, and much of the state is experiencing shortages in primary care as well. The DNP graduates will play a key role in helping to meet those health care needs in the state of Wyoming.”

UW’s DNP program offers two options: 1) family nurse practitioner (FNP), which prepares nurse practitioners (NPs) to practice as primary care providers and 2) family psychiatric mental health nurse practitioner (FPMHNP), which prepares NPs to practice as mental health providers. Both FNPs and FPMHNPs are prepared to diagnose and manage illness, including medication prescribing.

Wyoming’s health care community recognized the need to bolster both primary care and psychiatric care in Wyoming, and fully supported the move to the new DNP program, says Associate Professor Ann Marie Hart, the DNP program director. She says the program offers training in the basic skills required to practice nursing, as UW previously offered at the master’s degree level, but adds a lot more.

Shepard says she was attracted to the program because of the strong emphasis on patient behavior changes.

“Too often, we prescribe change to a patient, such as a medication, and the patient has no intent on completing the behavior or making any other needed changes,” she says. “By focusing on the behavior change aspect, the patient takes the lead in making the change and working with the provider on developing an effective plan of care that is individualized to their needs. The behavior change helps the NP provide effective individualized care and develop a partnership with the patient, which is why it is an essential approach.”

The DNP program is attractive to people who want to work in rural areas, Burman says. Hart adds that many nursing students do their required rotations in rural areas.

“We find they want to stay and work in communities such as Saratoga, Guernsey, Lusk, Pinedale, the Wind River Reservation and other areas where they contribute to meeting community health care needs,” she says.

Shepard, who will serve a fall clinical placement at the Spruce Medical Clinic in Rawlins, agrees.

“I love living in a small town where you know everyone and people are always willing to help out a neighbor,” she says. “Providing care in a rural community, a provider gets to build ongoing relationships with patients, their families and the community, and this is appealing to me.”

She adds that many rural community members have a hardiness factor that makes it challenging for people to seek health care

“Adding the complications of lack of providers and having to travel causes rural community members to be even more hesitant to receive care,” Shepard says. “I want to provide care in a rural community so that there is continuity of care and someone that they can always count on.”

“Now, we are providing a new set of skills that emphasize behavior and lifestyle changes that add some really exciting things to expand primary care and mental health care in Wyoming,” she says.

Shepard appreciates the skills that are offered in the program.

“One unique aspect that I think UW offers is instructors with a true passion and determination to teach and mold high-quality NPs,” she says. “The instructors will do everything they can to assist with the learning process and address concerns. The instructors are very approachable and are always willing to extend a helping hand.”

The DNP is among other School of Nursing programs that play a role in meeting Wyoming’s health care needs. The school offers a program with the community colleges to teach the associate degree with a transition to the bachelor’s degree (RENEW); an accelerated BSN through the Outreach School (BRAND); and an option for RN/BSN completion online.

Other College of Health Sciences units also provide significant value to the state through education and outreach, including the School of Pharmacy, and Divisions of Communication Disorders, Social Work, Kinesiology and Health, Wyoming Institute for Disabilities, and Medical Education and Public Health/Family Medicine Residency Programs.